T3-Craniostenosis

Question 1

What is craniosynostosis (craniostenosis)?

Answer 1

Premature closure of the sutures or absence of sutures in skull

Question 2

What does craniostenosis result in?

Answer 2

Various skull deformities

Question 3

Patho of craniosynostosis: Premature closure or absence of sutures of the skull with normal brain growth can lead to displacement of ____, which leads to increased ____, which leads to what 4 things?

Answer 3

Displacement of CRANIAL CONTENTS–> INCREASED ICP–>Decompensation to seizures to coma to death

Question 4

Craniosynostosis: clinical manifestations–Malformation of the _____

Answer 4

Cranial symmetry

Question 5

Craniosynostosis: Clinical manifestations–Early coronal sutures will show what?

Answer 5

Depression of the orbital roof leading to visual changes such as exopthalmia, strabismus and other eye findings

Question 6

Craniosynostosis: Other signs of increased ICP are? (7)

Answer 6

• Headaches
• Irritability
• HIGH pitched cry
• Vomiting
• Visual changes
• Ataxia
• Seizures

Question 7

If craniostenosis is not treated what may happen?

Answer 7

Brain damage and mental retardation

Question 8

What is treatment of craniostenosis?

Answer 8

Reconstructive surgery of the skull

Question 9

Craniosynostosis: How often do we do positional changes in newborns and infants?

Answer 9

Frequenly

Question 10

What device is used in positional plagiocephaly?

Answer 10

Helmet device

Question 11

What age is helmet device most effective?

Answer 11

Less than 9 months old

Question 12

If the child is 3 months old, how many hours a day do they use the helmet device?

Answer 12

23 hours

Question 13

What is the pre op care for craniotomy/craniectomy?

Answer 13

• Informed consent
• NPO
• Prophaylactic meds

Question 14

What are the prophylactic meds for craniotomy/craniectomy?

Answer 14

• Antibiotics
• Steroids
• Others as ordered

Question 15

• KNOW THIS: Nursing responsibilities post-op for craniotomy/craniectomy:
  1. Observe for what signs?
  2. What assessment?
  3. What kind of edema?
  4. What site care?
  5. What control?
  6. What education?

Answer 15

1. Signs of periorbital edema, changes in vision, and ICP
2. Neuro assessment
3. Cerebral edema
4. Surgical site care
5. Pain control
6. Parent education

Question 16

Craniostenosis: What type of support of the parent is essential?

Answer 16

Emotional support

Question 17

Post op craniostenosis:

• Do what to reduce swelling?
• Why do we carefully monitor HCT/HGB?

Answer 17

• Pressure dressing to reduce swelling

- Carefully monitor HCT/HGB because infants heads are so vascular